Individual provider Active NPI

Osvaldo Niebla Diaz, M.D.

  • General Practice Physician
  • Guaynabo, PR
National Provider Identifier
1174550131
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15476 Issued in PR
Practice address
112 Acuarela. Quintavalle
Apto. 118
Guaynabo, PR 00969-3599
Phone
(787) 708-1712
NPI assigned
Jun 27, 2006
Last updated
Jan 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 15476 PR Primary

Addresses

Primary practice location

112 Acuarela. Quintavalle
Apto. 118
Guaynabo, PR 00969-3599

Mailing address

112 Acuarela. Quintavalle
Apto. 118
Guaynabo, PR 00969-3599
Phone (787) 708-1712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050119000216 PR Practitioner - Family PracticePractitioner - General Practice 9234188079 Practice locations: Manati, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15476PRMDGeneral Practice Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1174550131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 ACUARELA. QUINTAVALLE",
            "address_2": "APTO. 118",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009693599",
            "telephone_number": "787-708-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 ACUARELA. QUINTAVALLE",
            "address_2": "APTO. 118",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009693599",
            "telephone_number": "787-708-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEBLA DIAZ",
        "first_name": "OSVALDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.